Total Endoprosthesis Versus Lundborg´s Resection Arthroplasty for the Treatment of Trapeziometacarpal Joint Osteoarthritis

Abstract

Background:There exist various operative approaches for the treatment of trapeziometacarpal joint osteoarthritis. The aim of this study was to compare the results of Lundsborg’s resection arthroplasty (RA) with implantation of a total endoprosthesis.Patients and Methods:In this 2-center study, we retrospectively analyzed 71 patients with symptomatic osteoarthritis of the carpometacarpal I joint stage III according to the Eaton-Littler classification. Thirty-two patients underwent a Lundsborg’s RA group, and 39 patients received a total endoprosthesis of the carpometacarpal I joint (TEP group). We evaluated operative time, DASH score, postoperative time until resolution of symptoms, pain level, pinch force, and satisfaction with the treatment.Results:Both groups had a similar mean length of follow-up of 42 months (TEP group) and 36 months (RA group). The final DASH score was significantly better in the TEP-group (10.1 versus 21.5 in the RA group; P ≤ 0.05). Also, the time interval from surgery till absence of any pain (1.5 versus 5.9 months) and the time of inability to work (6 versus 21 weeks) were significantly shorter for the TEP group compared with the RA group (P ≤ 0.05). The pinch force, pain intensity, and the satisfaction with the treatment were comparable (P > 0.05). The duration of the operation was significantly shorter in the RA group (31 min versus 65 min in the TEP group; P ≤ 0.05).Conclusion:Both techniques resulted in improved function of the operated hand and a clear reduction of symptoms. However, the implantation of a total endoprosthesis seems to have advantages, given a significantly better DASH score and a significantly shorter time until resolution of symptoms.

Thumb CMCJ prosthetic total joint replacement: a systematic review

“…Quantifiable satisfaction scores were reported in seven studies, 8 , 11 , 16 , 22 , 24 , 39 , 40 and pain scores in 30 studies. 4 – 7 , 9 – 11 , 13 , 15 – 17 , 19 – 24 , 26 , 27 , 29 – 35 , 38 – 41 Comparable pre and post-operative values were reported in two studies for satisfaction, 16 , 39 and 16 studies for pain.…”

“…The IVORY prosthesis was reported in five studies, comprising two comparative cohorts, 21 , 22 and three descriptive cohorts, 20 , 23 , 24 with a total of 274 replacements. Two studies reported survival rates with cumulative survival analysis, demonstrating 95.5% survival at 10 years 20 and 96.4% survival at five years 21 respectively.…”

“…The resection arthroplasty groups underwent trapeziectomy with ligament reconstruction and tendon interposition (LRTI) using flexor carpi radialis (FCR) in five studies, 9 , 10 , 13 , 21 , 48 abductor pollicis longus (APL) in two studies, 22 , 41 extensor carpi radialis longus (ECRL) in one study, 15 and a synthetic interposition in one study 8 ( Table 4 ). Due to both the heterogeneity of surgical techniques and outcome measures, it was not possible to perform a meta-analysis of these data.…”

“…The other studies were comparative cohorts comparing ARPE, 8 – 10 IVORY, 21 , 22 Elektra, 15 , 41 and Beznoska 13 prostheses against resection arthroplasty. Follow up ranged from 12 months to 13.6 years.…”

Functional outcomes after surgery for thumb carpometacarpal joint arthritis

“…The only subjective data almost always recorded was pain. In the 46 total implant arthroplasty articles (excluding silastic replacements) published between 2000 and 2019 (Apard and Saint-Cast, 2007; Badia and Sambandam, 2006; Brikout and Rezzouk, 2016; Brutus and Kinnen, 2004; Caekebeke and Duerinckx, 2018; Cebrian-Gomez et al., 2019; Chug et al., 2014; Cootjans et al., 2017; Craik et al., 2017; De Smet et al., 2004; Dehl et al., 2017; Dreant and Poumellec, 2019; Erne et al., 2018; Goubau et al., 2013; Guardia et al., 2010; Hansen and Vainorius, 2008; Hernández-Cortés et al., 2012; Isselin, 2001; Jacoulet, 2005; Jager et al., 2013; Johnston et al., 2012; Kaszap and Daecke, 2012; Klahn et al., 2012; Kollig et al., 2017; Krukhaug et al., 2014; Lemoine et al., 2009; Maes et al., 2010; Martin-Ferrero, 2014; Masmejean et al., 2003; Moutet et al., 2001; Pendse et al., 2009; Pérez-Ubeda et al. 2003; Regnard, 2006; Robles-Molina et al., 2017; Schuhl, 2001; Semere et al., 2015; Seng and Chantelot, 2013; Spaans et al., 2016; ten Brinke et al., 2016; Thillerman et al., 2016; Toffoli and Teissier, 2017; Ulrich-Vinther et al., 2008; Vander Eecken et al., 2012; van Rijn and Gosens, 2010; Vissers et al., 2019; Zollinger et al., 2008) functional scores were used infrequently (Table 1).…”